Faculteit der wiskunde en natuurwetenschappen

Introduction:  Minor oral  salivary  glands exist in large numbers  in the labial, buccal  and palatal mucosa, and account for approximately half of the baseline secretion of saliva. They can be transplanted together with the overlying mucosa as a complex graft to the posterior  lamella of the eyelids to increase ocular surface lubrication and reduce discomfort in dry eyes. Material and Methods: The surgical methods and the results of this technique in  17 patients  are described. All patients had been retractive to medical treatment. The recipient bed over the lower or upper lid retractors and a donor tissue of lower labial mucosa with  its submucosal minor salivary glands of approximately 2.5 X  2 cm were prepared by means of a surgical knife  or Ellman Surgitron high-frequency/low-temperature radiosurgical device. The graft was cut in two strips of approximately 2.5 X 1 cm size and sutured to the recipient site with interrupted or running sutures. The labial wound was left open for second intention healing. Results: All  grafts remained viable and vascularised  within  1 week. Vascularisation  of the graft was associ­
ated with an improvement of symptoms and increased  ocular  surface  lubrication.  Complications included temporary labial hypaesthesia, partial necrosis of the graft (n =  I ), herpes simplex virus keratitis (n =  I ) and epiphora (n  =  1). Viable glandular tissue was found  in specimens taken 18 and 36 months postoperatively. Other reported complications include lid malpositioning such as ptosis and entropium. Conclusion: Transplantation of minor salivary glands is a promising new treatment option for severe dry eyes. The procedure is simple with minimal surgical risks. These grafts remain viable in over 90% and seem to be capable of sus­ taining a basal secretion for up to 36 months. Since experience with this technique is still very limited, prospective controlled studies have to be performed  to establish the long-term  survival of the glands and to characterise the salivary tear film and its impact on the ocular surface.

A relatively simple combination of Schirmer strip sampling with straightforward sensitive nanoLC quadrupole-Orbitrap tandem mass spectrometry after a minimum of sample processing steps allows for replicate proteomic analysis of single human tears, i.e., without the requirement for sample pooling. This opens the way to clinical applications of the analytical workflow, e.g., to monitor disease progression or treatment efficacy within individual patients. Proof of concept is provided by triplicate analyses of a singular sampling of tears of a dry eye patient, before and one and two months after minor salivary gland transplantation. To facilitate comparison with the outcome of previously reported analytical protocols, we also include the data from a typical healthy young adult tear sample as obtained by our streamlined method. With 375 confidently identified proteins in the healthy adult tear, the obtained results are comprehensive and in large agreement with previously published observations on pooled samples of multiple patients. We conclude that, to a limited extent, bottom–up tear protein identifications from individual patients may have clinical relevance.

Purpose: To evaluate the transconjunctival lower lid blepharoplasty using a Desmarres lid retractor to evert the eyelid. Design: Prospective study. Methods: Twenty-one cases of inferior blepharoplasty in 11 patients, performed through a transconjunctival approach are reported. The author describes the surgical technique with Radio Frequency surgery, the use of a Desmarres lid retractor to evert the eyelid and the results. Results: Radio Frequency surgery and the use of a Desmarres lid retractor appear to give excellent results in transconjunctival lower lid blepharoplasty. Everting instead of retracting the eyelid provides excellent access to the fat pockets in the lower lids with less bleeding thanks to the traction on the eyelid. The transconjunctival approach has a lower complication rate than the classic transcutaneous approach, with no visible scar and less risk of postoperative scleral show or ectropion. Conclusion: Radiosurgically assisted transconjunctival blepharoplasty of the lower lid with the use of a Desmarres lid retractor is associated with a good functional and cosmetic outcome.

Purpose: To evaluate the transconjunctival lower lid blepharoplasty using a Desmarres lid retractor to evert the eyelid.
Design: Prospective study.
Methods: Twenty-one cases of inferior blepharoplasty in 11 patients, performed through a transconjunctival approach are
reported. The author describes the surgical technique with Radio Frequency surgery, the use of a Desmarres lid retractor
to evert the eyelid and the results.
Results: Radio Frequency surgery and the use of a Desmarres lid retractor appear to give excellent results in transconjunctival
lower lid blepharoplasty.
Everting instead of retracting the eyelid provides excellent access to the fat pockets in the lower lids with less bleeding
thanks to the traction on the eyelid.
The transconjunctival approach has a lower complication rate than the classic transcutaneous approach, with no visible scar
and less risk of postoperative scleral show or ectropion.
Conclusion: Radiosurgically assisted transconjunctival blepharoplasty of the lower lid with the use of a Desmarres lid
retractor is associated with a good functional and cosmetic outcome.

We describe a familial mental retardation syndrome in a 30 year old, moderately mentally retarded female and her 59 year old maternal aunt. Both presented the distinct association of (1) a nonprogressive neurological syndrome with ataxia and hypotonia, (2) similar craniofacial appearance with a narrow forehead, prominent supraorbital ridges and tendency to synophrys, deeply set eyes with short, upward slanting palpebral fissures, short philtrum, and large mouth, (3) hypergonadotrophic hypogonadism, and (4) retinal dystrophy with onset in early adulthood.

We describe a familial mental retardation syndrome in a 30 year old, moderately mentally retarded female and her 59 year old maternal aunt. Both presented the distinct association of (1) a nonprogressive neurological syndrome with ataxia and hypotonia, (2) similar craniofacial appearance with a narrow forehead, prominent supraorbital ridges and tendency to synophrys, deeply set eyes with short, upward slanting palpebral fissures, short philtrum, and large mouth, (3) hypergonadotrophic hypogonadism, and (4) retinal dystrophy with onset in early adulthood.

Please cite this article as: Peter Raus, Bharath Kumar Raguraman, Martijn Pinkse, Peter Verhaert, Bottom-up protein identifications from microliter quantities of individual human tear samples.Important steps towards clinical relevance., European Journal of Integrative Medicine http://dx.

Purpose: To evaluate the transconjunctival lower lid blepharoplasty using a Desmarres lid retractor to evert the eyelid. Design: Prospective study. Methods: Twenty-one cases of inferior blepharoplasty in 11 patients, performed through a transconjunctival approach are reported. The author describes the surgical technique with Radio Frequency surgery, the use of a Desmarres lid retractor to evert the eyelid and the results. Results: Radio Frequency surgery and the use of a Desmarres lid retractor appear to give excellent results in transconjunctival lower lid blepharoplasty. Everting instead of retracting the eyelid provides excellent access to the fat pockets in the lower lids with less bleeding thanks to the traction on the eyelid. The transconjunctival approach has a lower complication rate than the classic transcutaneous approach, with no visible scar and less risk of postoperative scleral show or ectropion. Conclusion: Radiosurgically assisted transconjunctival blepharoplasty of the lower lid with the use of a Desmarres lid retractor is associated with a good functional and cosmetic outcome.

Purpose: "Dry Eye is a condition produced by the inadequate interrelation between lacrimal film and ocular surface epithelium, and is caused by quantitative and qualitative deficits in one or both of them. It can be produced by one or combined etiologic causes, affecting one or several of the secretions of the glands serving the ocular surface, and producing secondary manifestations of different grades of severity". Clinicians need a practical classification to face diagnosis, prognosis and treatment. Dry eyes have many etiologies and pathogenesis, different affectation of the various dacryoglands and ocular surface epithelium, and diverse grades of severity. The specialists in xero-dacryology must know these three parameters to evaluate any case of dry eye, and to establish an adequate treatment. Methods: To facilitate this, an open session in the 8th congress of the International Society of Dacryology and Dry Eye (Madrid, April, 2005) proposed modifying the Triple Classification of dry eye approved in the XIV congress of the European Society of Ophthalmology (Madrid, June, 2003). There was consensus of all conclusions. Conclusions: The following classification has been established: First, a classification of the etio-pathogenesis, distributed in ten groups: age-related, hormonal, pharmacologic, immunopathic, hyponutritional, dysgenic, infectious/inflammatory, traumatic, neurologic and tantalic. Second, a classification of the affected glands and tissues, which under the acronym of ALMEN includes the Aqueo-serousdeficient, Lipodeficient, Mucindeficient and Epitheliopatic dry eyes, and the Non dacryological affected exocrine glands (saliva, nasal secretion, tracheo-pharyngeal secretion, etc). And thirdly, a classification of severity, in three grades: Grade 1 or mild (symptoms without slitlamp signs), grade 2 or moderate (symptoms with reversible signs), and grade 3 or severe (symptoms with permanent signs).

Herein, we report a highly selective C−H olefination of directing-group-free indolines (C5) and tetrahydroquinolines (C6) by Pd/S,O-ligand catalysis. In the presence of the S,O-ligand, a wide range of challenging indolines, tetrahydroquinolines, and olefins was efficiently olefinated under mild reaction conditions. The synthetic potential of this methodology was demonstrated by the efficient olefination of several indoline-based natural products.